Clinical efficacy and safety of second line and salvage aflibercept for advanced colorectal cancer in Akita prefecture
| Autor: | Taichi Yoshida, Koji Fukuda, Kentaro Takahashi, Fuminori Ono, Yuko Yoshida, Kyoko Nomura, Osamu Muto, Hiroyuki Shibata, Kazuhiro Shimazu, Daiki Taguchi, Kengo Shibuya |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Oncology
endocrine system medicine.medical_specialty endocrine system diseases Colorectal cancer Observational Study Second line chemotherapy Second-line chemotherapy Advanced colorectal cancer 03 medical and health sciences 0302 clinical medicine Second line Internal medicine Medicine Clinical efficacy Aflibercept Folinic acid-fluorouracil-irinotecan business.industry Gastroenterology Palliative chemotherapy medicine.disease 030220 oncology & carcinogenesis Observational cohort study 030211 gastroenterology & hepatology business hormones hormone substitutes and hormone antagonists medicine.drug Cohort study |
| Zdroj: | World Journal of Gastrointestinal Oncology |
| ISSN: | 1948-5204 |
| Popis: | BACKGROUND Angiogenesis inhibitors (AIs) combination with cytotoxic chemotherapy is a promising treatment for patients with colorectal cancer (CRC). Aflibercept (AFL) is an option for second-line treatment of CRC, according to the ‘VELOUR’ trial. Currently, we can choose from three AIs, including bevacizumab, ramucirumab, and AFL. Different AIs can be used in subsequent treatment because of their distinctive mechanisms of action. We addressed the uncertainty regarding AFL efficacy and safety in heavily-treated patients by comparing outcomes of survival treatment with second-line treatment. AIM To determine and compare the efficacy and safety profiles of AFL in the second-line and salvage therapy settings. METHODS Clinical data of 41 patients with advanced CRC who received intravenous AFL combined with the folinic acid-fluorouracil-irinotecan (FOLFIRI) regimen were collected retrospectively from six institutions in Japan, for the period from May 2017 to March 2019. Patient characteristics collected included age, sex, tumor location, RAS and RAF status, metastatic sites, number of previous treatment cycles, therapeutic response, adverse events, duration of previous AI treatment, and survival time. The end points were time to AFL treatment failure (aTTF) and median survival time post-AFL (aMST). Statistical analyses were performed to compare the efficacy and safety in the second-line setting with those of the salvage therapy setting, which was defined as the days since the end of second-line therapy. RESULTS All 41 patients who received AFL + FOLFIRI for advanced CRC had metastatic or unresectable cancer. Twenty-two patients received AFL in the second-line setting and nineteen in the salvage therapy setting. The patient characteristics were similar in the two groups, except for two factors. The median duration of the previous AI administration was shorter in the second-line patients compared with that in the salvage therapy patients (144 d vs 323 d, P = 0.006). In the second-line and salvage therapy groups, the objective response rates were 11% and 0%, respectively (P = 0.50), and the disease control rates were 53% and 50%, respectively (P = 1.00). In the second-line and salvage therapy groups, the aTTF (123 d vs 71 d, respectively), aMST (673 d vs 396 d, respectively), and incidence of adverse events of grade 3 [8 (36%) vs 9 (47%)] were not significantly different between the two groups. CONCLUSION AFL can be used to treat advanced CRC patients, with a similar safety and efficacy in the salvage therapy setting as in the second-line setting. |
| Databáze: | OpenAIRE |
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